Jonathan Bornstein Deft Touch Soccer Academy
Small Group Training Based on all Aspects of the Game
Jonathan Bornstein Deft Touch Soccer Academy Registration Form *
Ages 5-13 years (Academy Runs Year Round)
Athletes Name: *
Jonathan Bornstein
Your answer
Date of Birth: *
10/10/2001
Your answer
Emergency Contact Name: *
Jonny Bornstein
Your answer
Emergency Contact Phone Number: *
555-555-5555
Your answer
Your answer
Playing Experience: *
Check the Highest Level Currently Playing (High School Players Include HS Level)
Required
Deft Touch Soccer Center Online Waiver Completion *
Parent/Guardian Completed Online Waiver @ www.defttouchsc.com
Required
Academy Participation *
9-13yrs Monthly
Payment Option: *
Paypal Reoccurring Payment
Academy Start Date *
Date Athlete is Starting the Academy (06/07/2013)
Your answer
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